关于重症监护后综合征患者多模式康复的指南
Caroline Renner1, Marie-Madlen Jeitziner2,3, Monika Albert4
1Department of Neurology and Neuro-Rehabilitation, Herz-Kreislauf-Zentrum, Klinikum Hersfeld-Rotenburg GmbH, Rotenburg a. F., University of Leipzig, Leipzig, Germany.
Critical care (London, England)
|July 31, 2023
概括
后重症监护综合征 (PICS) 康复需要一个多学科的方法. 指导方针建议对ICU幸存者进行早期动员,运动训练,营养,妄想预防和心理支持.
科学领域:
- 关键护理医学 关键护理医学
- 康复医学 康复医学 康复医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 重症监护室 (ICU) 的幸存者经常经历身体,认知和心理障碍,这些障碍被统称为重症监护后综合征 (PICS).
- 开发有效的PICS康复策略对于改善患者的治疗结果至关重要.
- 目前对PICS管理的指导方针是必要的,以应对其复杂和可变的性质.
研究的目的:
- 制定一个多学科和多专业的指导方针,用于重症监护综合征 (PICS) 的康复治疗.
- 为预防和治疗PICS提供基于证据的建议.
主要方法:
- 一个由15名医疗保健专业人员组成的特别工作组采用了结构化,基于证据的方法.
- 解决了十个PICO (人口,干预,比较,结果) 问题,以确定最好的可用证据.
- 建议使用推,评估,发展和评估 (GRADE) 原则进行分级.
主要成果:
- 证据综合导致12个建议,4个治疗选择和1个关于PICS预防和治疗的陈述.
- 关键干预措施包括早期动员,运动训练,营养/消化不良管理,以及用于妄想预防的行为干预.
- 强化护理日记是建议用于预防/治疗心理问题,如焦虑和PTSD.
结论:
- 后重症监护综合征 (PICS) 是一种复杂的疾病,需要个性化,多学科和多专业的方法.
- 康复必须包括对运动,认知和心理障碍的评估和治疗.
- 定期和反复评估是有效PICS治疗的先决条件.
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